ObjectiveTo report the effect and experience of the extended resection and reconstruction of superior vena cava(SVC) and innominate vein for invasive mediastinal tumors.MethodsA retrospective study of 11 patients who underwent extended resection and grafts of SVC and innominate vein for invasive mediastinal tumor in Peking Union Medical College Hospital from 2001 to 2003 was performed. Radical resection was performed in 9 cases, among which SVC and left innominate vein were reconstructed with pericardium patch in 2, with prostheses(ringed GoreTex) interposed in 7.The other 2 patients who had incomplete resection also underwent prostheses interposition for SVC reconstruction. During operation, SVC and left innominate vein were clamped in turn,to avoid total interruption of blood return, clamping time for each site was 22.15±6.29 min. The volume of blood loss was 1 342.86± 692.48ml during operation.ResultsThe tumor included 4 invasive thymoma, 5 thymic cancer, 2 primary mediastinal small cell carcinoma. The patency was good in the grafts with external ring support and no SVC symptoms were observed in all cases postoperatively. One patient died of respiratory infection two weeks after operation, others are alive till now. The longest patent and functional graft is 30 months postoperatively.ConclusionSVC and innominate vein reconstruction by prostheses interposition can effectively eradicate the SVC syndrome. Clamping SVC needs careful study. Attention to the invasive extention of tumor should be made to avoid palliative operation,because complete resection is most important for long term survival.
Citation： WANG Zhenjie ,YU Hongquan,REN Hua,et al .. Extended Resection and Reconstruction of Superior Vena Cava and Innominate Vein for Mediastinal Tumor. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2005, 12(1): 221-25. doi: Copy